Individual provider Active NPI

Roberta H McDuffie, CNS

  • Clinical Nurse Specialist
  • New Orleans, LA
National Provider Identifier
1104933167
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
AP03420 Issued in LA
Practice address
1415 Tulane Ave
New Orleans, LA 70112-2600
Phone
(504) 988-2623
Fax
(504) 988-8886
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 78019-3420 LA
Clinical Nurse Specialist 364S00000X AP03420 LA Primary

Addresses

Primary practice location

1415 Tulane Ave
New Orleans, LA 70112-2600

Mailing address

1415 Tulane Ave
SL 53
New Orleans, LA 70112-2600
Phone (504) 988-0299

Other identifiers 1

IdentifierTypeStateIssuer
1458465MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
78019-3420LAMDSpecialist
AP03420LAMDClinical Nurse Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1104933167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 TULANE AVE",
            "address_2": "SL 53",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122600",
            "telephone_number": "504-988-0299",
            "fax_number": "504-988-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 TULANE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122600",
            "telephone_number": "504-988-2623",
            "fax_number": "504-988-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDUFFIE",
        "first_name": "ROBERTA",
        "middle_name": "H",
        "name_prefix": "Ms.",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "78019-3420",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "LA",
            "license": "AP03420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1458465",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.